The Brazilian Ministry of Health has institutionalized two articulated processes in the field of health technology management: (i) the production, systematization and dissemination of health technology assessment, and (ii) the adoption of a flow for the incorporation, exclusion or alteration of new technologies by the Brazilian National Health System. Several advances have been made, such as standardization of methods; production and promotion of studies; institutional development and international cooperation in the area of health technology assessment; definition of the necessary requirements for the presentation of proposals; definition of deadlines; and expansion of the segments that compose the committee that is responsible for the analysis and recommendation. However, some difficulties remain: health technology assessment activities concentrated in the Ministry; low sustainability of the activities of production and dissemination of the assessments; low penetration of health technology assessment in health care institutions; activities of assessment/incorporation with low participation of users; non-transparent decision-making processes; and low integration of the health policy with the scientific and technological policy.46 Suppl 183-90